New Coronavirus Revives SARS Memories

A man critically ill in a British hospital has a novel coronavirus, a relative of the pathogen that caused the 2002-2003 outbreak of severe acute respiratory syndrome (SARS), according to the U.K.'s Health Protection Agency.

It's the second time the virus has been found -- it was previously identified in a patient who died in Saudi Arabia 3 months ago, the agency reported.

The critically ill patient, a 49-year-old man originally from Qatar, had recently traveled to Saudi Arabia and had become ill Sept. 3. He was admitted to intensive care in Doha, Qatar, on Sept. 7 with a respiratory illness and renal failure and was subsequently airlifted to the U.K. on Sept. 11.

Sequencing suggested the viruses isolated from the two patients are 99.5% identical, with just one nucleotide mismatched over the regions that were compared, according to the World Health Organization.

"We appear to have two cases with coronaviruses that are clearly related, suggesting a common source," commented Donald Low, MD, of Mount Sinai Hospital in Toronto, who was one of the leaders in the battle against SARS.

But it's too early to say what the impact of the novel virus will be on the public, Low told MedPage Today.

He noted that the early signs of SARS were relatively innocuous. "It percolated along," Low said, with a few cases here and there. "It was only when it got into the hospital setting, where there was lack of adequate infection control, that it really started going."

But coronaviruses are RNA viruses and notoriously given to genetic variation; sometime early in the outbreak the SARS virus had a genetic change that made it more infectious -- something that investigators will keep an eye out for in the new virus.

Much about the new virus remains unclear, according to the UK public health agency, including where it comes from, how widespread it is, how contagious it is, and how to treat it.

"The virus has so far only been identified in two cases of acute, serious respiratory illness who presented with fever, cough, shortness of breath, and breathing difficulties," the agency said in a statement.

"At this point it is not clear whether these cases are typical of infection with this virus or whether it could be circulating more widely, but causing a milder illness, and only very rarely causing a severe illness," the statement continued.

Low said it's possible that the two cases represent the first detected signs of a wider but milder outbreak that has remained in the shadows, but that seems unlikely, given surveillance systems that are "incredibly better" than they were a decade ago.

"We get samples sent in all time, described as 'respiratory illness undefined'," said Low, who until recently was also medical director of Public Health Ontario's microbiology laboratories.

"So people are looking and I don't think they're finding (new coronaviruses) all that often," he said.

Nonetheless, the findings are worrisome, especially since the annual Hajj pilgrimage to Mecca is set to begin soon and will bring millions of people to the Middle East.

The WHO said online it is not yet suggesting any travel restrictions to and from the region.

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